Orthopedic appliance



July 19, 1938.

w. BELL ORTHOPEDIC APPLIANCE Filed 001:. 28, 1955 INVENTOR WILLIAM L. BELL ATTORNEY v Patented July 19, 1938 UNITED STATES ORTHOPEDIC APPLIANCE William L. Bell, Oakland, Calif, assignor to Gilbert Hyde Chick, Oakland, Calif.

Application October 28, 1935, Serial No. 47,065

6 Claims.

This invention relates to improvements in orthopedic appliances and more particularly to traction means for surgical tables.

An object of the invention is to provide an accessory for surgical tables, capable of applying, traction or extensive forces to the anatomy of a patient supported on the table.

Another object is to apply tortional and/or extensive forces to the limbs of the patient.

Another object is to hold the limb of a patient at a fixed angle to the axis of the torso.

Another object is to hold the extremities, such as the hands or feet at a fixed angle to the axis of the limbs of which they are parts.

Another object is to render the application of corrective forces in the various planes mutually independent so that one of the forces may be varied without disturbing the adjustment of the other forces.

Another object is to facilitate the exposure of the limbs of the body to X-ray examination and photography.

A further object is to facilitate surgical technique and/or the application of plaster casts or other orthopedic corrective practice to the human anatomy.

Other objects and advantages will appear as the description progresses.

In modern surgery and orthopedic practice X-ray examination and photography is very essential in diagnosis and accuracy in setting fractures and applying corrective appliances. The present invention provides a full range of angularity in applying corrective stresses to the anatomy without interposing opaque apparatus between the X-ray and the photographic plate or the eye of the operator.

The present invention is particularly adapted as .an accessory for use in connection with the operating table disclosed in the copending application, Serial No. 47,066, filed October 28, 1935, entitled Orthopedic apparatus.

In this specification and the accompanying drawing the invention is disclosed in its present preferred form. It is to be understood, however, that it is not limited to this form because it may be embodied in modifications within the purview of the claims following the description.

In the one sheet of drawings:

Fig. 1 is a side elevation of a traction unit in combination with an orthopedic apparatus.

Fig. 2 is a similar view in enlarged detail of the pivotal traction head of the same partially in vertical section.

Fig. 3 is a rear view of the same partially in vertical section on the line III-III, Fig. 2.

Fig. 4 is a plan view detail, from above, of the heel rest, and

Fig. 5 is a similar detail of the toe stirrup.

In detail the construction illustrated in the drawing, referring first to Fig. 1, comprises the traction unit which includes the spar I, preferably square in cross section for strength and rigidity. The spar is pivoted on a vertical gud-- geon pin 2, fixed in the bracket 3, slidable on the side bar 4 of the frame of the supporting table, not shown in detail. The bracket is locked in adjusted position on the bar 4 by the set screws 5. And the spar is locked in its arcuate swing by the quadrant plate 6, fixed on the pin 2 on the opposite sides of which the spar I and the clamp bar I are drawn together by the man- ,ual screw means 8.

The spar is provided with an encircling sleeve 9 slidable thereon and fixed in any desired adjusted position by the set screw [0. This sleeve has the lateral vertical socket II and the set screw i2, to receive and hold the tubular standard l3.

The rod 14 telescopes within the standard and is held by any adjusted horizontal angle or height by the set screw I5. This rod has the yoke l6 fixed upon its upper end, see Fig. 3. The disk ll is pivoted in this yoke on the horizontal cross pin H3. The set screw I9 is threaded through one leg of the yoke and bears against the side of the disk I! to hold it in adjusted position.

The tubular guide 26 is welded onto the neck 2! extending from the periphery of the disk. The barrel 22 encircles and is slidable on the guide and has the slot 23 passing the neck 2|. The rear end of this barrel has the plug 24 fixed therein. The screw spindle 25 is threaded in the nut 2i and is swiveled in the plug 24 between the collar 26 and the hand crank 21 fixed on the spindle. When the hand crank is rotated the spindle engaging the nut advances or retracts the barrel with respect to the disk'l.

The shank 28 is rotatable within the forward end of the barrel 22, but is held against withdrawal by the pin 29 fixed in the barrel and engaging an annular groove 29' in the shank. The rotation of the shank is stopped by the set screw 30, threaded through the wall of the barrel and engaging the shank. The end of the shank is flattened at 3| and has the transverse slot 32 therethrough.

The heel rest 33 has the split stem 34 engaging the flat portion 3| with the transverse pivot bolt 35 passing through the flat portion. The hand screw 36 passing through the slot 32 acts to clamp the split stem 34 in adjusted position on the flattened portion of the shank 28. When the heel of the patient is placed in the heel rest 33, the foot can be tipped at any desired angle and the axis of the shank 28 can be arranged in alinement or at an angle to the long axis of the patients leg, by means of the adjusting screw 30. The opening 33' in the heel rest forms a square edge around which the foot bandage may be wound. The lug 33" retains the bandage in place on the heel rest.

The slotted standard 31 extends upward from the shank 28. The toe stirrup 38 has the slotted yoke extension 39, straddling and adjustably fixed to the standard 31 by the thumb screw 40, for holding the patients foot in adjusted relation to the heel rest 33. The guard 4| extending outward from the stirrup 38 holds the foot from swinging laterally ofi the stirrup.

When the patients foot is bandaged to the heel rest 33, traction can be applied to .the patients leg by turning the hand crank 21 to advance or retract the supporting barrel 22. This traction unit works in conjunction with a perineal post on the operating table, not shown, or any other suitable anchorage to oppose the traction stresses applied.

' If a similar spar and traction unit is available on the opposite side of the table, the patient can by bracing his other leg absorb most of the stress of the traction applied. It is obvious that through the various adjustments of the spar assembly with respect to the supporting table, the various adjustments in the supporting standard l3--l4 of the traction unit, and the universal motions possible with the foot support, all the motions provided by the articulations of the human limb can be accomplished and-held indefinitely by this apparatus in setting fractures or applying corrective measures. In the case of displaced knee bones, while the leg is under traction, the set screw 30 can be released and the patients foot rapidly oscillated, with the result that the displaced bones of the knee return to proper interrelation without palpation of injured .tissue. Traction can then be reduced, the screw 30 reset and the knee bandaged or set in plaster as indicated.

By swinging the spars at the proper angles to the sides of the table, similar rotative and tractive stressesmay be applied to the arms and shoulders of the patient by setting his elbows in the heel rests 33 and his forearms in the toe stirrups 4| and bandaging them thereto. Or full length arm stresses may be applied by bandaging the hands to the heel or toe members mentioned.

By setting the angle of the spar oblique to the longitudinal axis of the patients limb, thelimboverhanging beyond the side of the table is fully accessible forX-ray exposure without intervening orthopedic apparatus.

The uses and possible combinative modes of operation are so extensive that. in actual practice over a period of many months this invention has never failed to meet every condition required of it, with mechanical and. merciful advantages too numerous to be set .forth herein.

Having thus described this invention, What is claimed and desired to secure by Letters Patent is:

1. An orthopedic apparatus including a support having a standard thereon; a disk pivoted on said standard and having a nut thereon; locking means on said standard engaging said disk; a barrel guided on said nut and having a spindle longitudinally swiveled therein, said spindle engaging said nut; a shank swiveled in said barrel and having a heel rest thereon; and a toe stirrup on said shank in adjustable relation to said heel rest.

2. An orthopedic apparatus including a horizontal support; a bracket longitudinally movable on said support; a spar movable horizontally on a vertical pivot on said bracket; a standard on said spar; a traction means on said standard and movable vertically and horizontally with respect to said standard; and foot supporting means pivoted on said traction means and movable vertically with respect thereto.

3; An orthopedic apparatus including a horizontal bar; a bracket longitudinally movable on said bar; a spar movable horizontally on said bracket; a sleeve movable longitudinally on said spar; a standard vertically movable on said sleeve; a traction means on said standard and movable vertically and horizontally with respect to said standard; and foot supporting means on said traction means and movable vertically with respect thereto.

4. An orthopedic apparatus including a support; a standard swiveled on said support whereby said sandard may be rotated in the horizontal plane with respect to said support; means for locking said standard against movement with respect to said support; traction means mounted on a horizontal pivot on said standard whereby said traction means may be rotated with respect to said standard in a single vertical plane; means for locking said traction means against rotary movement with respect to said standard; and a foot support mounted on said traction means.

5. An. orthopedic apparatus including a support having a standard thereon; a yoke on said standard; a disk having a horizontal pivot engaging said yoke; means for locking said disk against movement with respect to said yoke; traction means mounted upon said pivot; and a foot support mounted on said traction means.

6. An orthopedic apparatus including a support having a standard thereon, traction means transversely pivoted on said standard whereby said traction means may be rotated in the longitudinal vertical plane alone with respect to said standard; means for locking said traction means against rotary movement with respect to said standard; a foot support swiveled with respect to said traction means whereby said foot support may be rotated in a transverse vertical plane with respect thereto; and means for locking said foot rest against said rotary movement with respect to said traction means.

WILLIAM L. BELL. 

